Bipartisan support for county adult medical day care

Sunday

Jan 5, 2014 at 2:00 AM

The Rockingham County commissioners would have the public believe that closing the Adult Medical Day Care is the responsible thing to do from a financial and business perspective and that advocating its continued operation is a politically motivated position.

Rep. Donna Schlachman and Rep. Patrick Abrami

The Rockingham County commissioners would have the public believe that closing the Adult Medical Day Care is the responsible thing to do from a financial and business perspective and that advocating its continued operation is a politically motivated position.

So New Hampshire state representatives who believe that keeping our elderly medically compromised neighbors out of the county nursing home have political agendas? Those of us who believe that a continuum of care is important, and that spending $71/day to enable family members to stay in their home is better than the $350/day institutional care of the nursing home, are politically motivated? Really?

The Rockingham County Rehabilitation and Nursing Center Web site says this about its provision of services: "Because different levels of care are needed to serve the community, we support and operate a stepping stone approach ...; these services offer a safe, caring and sound system of care that allows families to choose the level of care that fits their needs and allows increased services when necessary."

The callous and irresponsible closure of the Adult Medical Day Care has removed an important and appropriate stepping stone. The county commissioners assert that this is OK because they have not heard from the "general public." They may not have, but we certainly have heard from many past and present family members. They have contacted us by snail mail, e-mail, phone calls and in person. As one Brentwood resident, who sees to the needs of her elderly in-laws next door, said upon hearing of the closure, "I was depending on this program to keep my in-laws in their home. I don't know what we will do; it was part of our plan for them." That there are 12 or 20 or 40 participants says little about how important this care is to those individuals and families served by the program.

For generations, the taxpayers of this county have supported the needs of our residents by maintaining good facilities and funding good programs. These services ensure a quality of life that New Hampshire strives to maintain. They are keeping housebound poor people fed, keeping troubled youth out of jail, and helping people stay out of a nursing home through the Adult Medical Day Care. The commissioners have stated as a reason for closure that it is inappropriate for the county to compete with private adult day care businesses. If we subscribe to the belief that the county should not do anything that could be handled by private entities, will we next see the closure of the entire nursing home and assisted living complex as well as the defunding of any county services that might have a counterpart somewhere in the world of private business?

The disagreement that we, and the vast majority of the members of the House of Representatives from Rockingham County (aka the county delegation) have with the county commissioners is about serving people. The commissioners' failure to act on the recommendations made by the county delegation to keep the program open and to better market and advertise it, and their failure to listen to the considerable testimony provided by individuals and families using the Adult Medical Day Care, is indefensible. As a recent piece by Nancy Russo in this paper so aptly points out, there was no outreach, no advertising, no true effort to increase the number of individuals served by the Adult Medical Day Care. Those medical professionals in the best position to advise families still do not know this program existed.

Instead of implementing changes to increase visibility and enrollment, the commissioners closed it to new admissions six months ago and made it known to anyone inquiring that the program was going to close Dec. 31. Unfortunately, there is nothing the people and their state representatives could do to stop this. The best we can do is express our outrage.

It is important for the public to know that when the county delegation approved money in this year's budget for this program it was with the understanding that the program would continue. The time to have these programmatic discussions is during the budget process. We funded the program with the clear message that the commissioners would do all in their power to make the program a success. Pulling the plug on this program mid-budget year is not the correct action. As far as the delegation is concerned, this program is still funded and should remain open.

Between now and the next budget process, interested parties from the delegation, our towns and the commissioners should meet to see how the program enrollment can be improved. Yes, there is a lower than anticipated usage, which is something that should be worked on. We are sure that if you ask the average citizen in Rockingham County whether there is a county-run Adult Medical Day Care Program, most would ask what is adult day care and then they would say they never heard of the county program. Marketing the program should get the numbers up and will go far to help the program break even. In watching the bottom line, however, we must appreciate that providing services to the elderly should not be viewed as a revenue source for the county. Even private for-profit adult day care programs struggle to break even and tend to be cross-subsidized by their other services.

Finally, contrary to assertions by the commissioners, this is in no way a partisan issue. Republicans and Democrats alike are upset by the closure of this program. Rest assured that some of the most fiscally conservative members of the county delegation voted for keeping this program alive even though it runs at a 15 percent loss. The Rockingham Nursing Home runs at a 26 percent loss. The only function of county government that requires no county tax dollars to function is the Registry of Deeds. The county portion of property tax bills has seen practically no increase in the past three years. Even with that we found the money to fund this important program.

The county delegation does an excellent job of balancing the burden placed on taxpayers with the need to maintain key programs for the benefit of our citizens, the Adult Medical Day Care being one of them. We believe the public would agree.

Rep. Donna Schlachman is a Democrat from Exeter. Rep. Patrick Abrami is a Republican from Stratham.

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